All The Books I Can Read

1 girl….2 many books!

Review: Dopesick by Beth Macy

on January 13, 2021

Beth Macy
Head Of Zeus
2019, 408p
Read via my local library

Blurb {from the publisher/}:

Beth Macy takes us into the heart of America’s struggle with opioid addiction. From distressed small communities in Central Appalachia to wealthy suburbs and once-idyllic farm towns, this powerful and moving story illustrates how a national crisis became so firmly entrenched.

At the heart of the narrative is a large corporation, Purdue – whose owners are celebrated for their sponsorship of art galleries and museums – that targeted areas of the country already awash in painkillers and encouraged small town doctors to prescribe OxyContin, a highly addictive drug. Evidence of its capacity to enslave its users was suppressed. Macy tries to answer a grieving mother’s question – why her only son died – and comes away with a harrowing story of greed and need.

Overtreatment with painkillers became the norm. In distressed communities of ex-miners and factory workers, the unemployed used painkillers both to numb the pain of joblessness and pay their bills. Macy’s portraits of the families, cops and doctors struggling to ameliorate this epidemic are unforgettable. But in a country unable to provide basic healthcare for all, Macy still finds reason to hope that there may be a decent future for people so abandoned by their political leaders. This is an essential book for anyone trying to understand the harrowing realities of Trump’s America.

This was…..eye opening. In so many ways.

The first time I really properly heard about America’s opioid crisis was a piece that John Oliver did on Last Week Tonight. This was one of the books I earmarked when I made a note to learn more about it and I found it both fascinating and also, heartbreaking. Reading from the perspective of an Australian, it’s also interesting to look at another facet of the American medical system and the ways in which big pharmaceutical companies push their drugs on doctors, teams dedicated to “courting them” with free dinners, vouchers, gifts, etc to make sure that their product is the one they have in mind when they reach for that prescription pad. Here, narcotics tend to be a bit of a last resort and they’re much more controlled. My husband has had several very serious and intensive operations – pain management is controlled intravenously for the first day or two, then they switch you to tablets and honestly, by the time he’s left hospital he’s twice been on only ibuprofen and paracetamol and the two times they did prescribe something stronger, it was one prescription, no repeats, enough tablets for one every six hours for about a week. Most of the time, he didn’t even finish them, switching to over the counter stuff or stuff available anywhere, after a few days. There are some truly disturbing stories here of people being prescribed potentially hundreds of serious painkillers for sprained ankles, thumbs, etc.

This book focuses on rural Virginia and the way in which OxyContin, a “new” (in the 1990s) pain pill, was touted as being incredibly low-risk for abuse due to addiction. Literally weeks after it was made available, people had discovered that if they crushed it and snorted it or injected it, that negated the slow-release part of the pill and they got about 70% of the dosage right away, providing a strong high and creating horrific addiction. Withdrawal from “Oxy” is as as bad as heroin – and after a long campaign by parents of kids who had been killed taking Oxy, the company that created and market it, Purdue Pharma, finally added a “blocker” to it, that took away the high feeling. When that feeling dried up, those addicted to it turned to heroin to get their fix. Both Oxy and heroin created waves of overdoses, often amount young people, those still in high school. It changed the mindset about who could get addicted, who this sort of thing could impact upon. That it wasn’t just street junkies this was happening to – but middle class, white, young (teens and 20s) people as well as others from all walks of life. And because it began in a small, mostly poor rural area, it was a long, long time before it was recognised as a problem. And by the time it was, by the time it had infiltrated cities and larger areas, the damage was done.

Beth Macy follows several parents in this, who lost their children to addiction and their fight to bring Purdue Pharma to justice for what they created and marketed and the ways in which they went about doing it. You hear a lot about the evils of big Pharma and Purdue embraced that with a passion it seemed, lacking in anything remotely resembling interest in people dying from their product as long as doctors were still prescribing it by the bucketload. I was gobsmacked how easy it was to score a decent supply of pills for really, the smallest of injuries – for some, it was a lucrative business, selling the pills they were prescribed to addicts desperate for the next fix. There were things they (Purdue) knew and hid, to get FDA approval and in the time since this book was been published, “it was reported that Purdue had reached a settlement potentially worth $8.3bn, admitting that it “knowingly and intentionally conspired and agreed with others to aid and abet” doctors dispensing medication “without a legitimate medical purpose”. Members of the Sackler family will additionally pay $225m and the company will close.” Many studies drew a direct line between Purdue’s marketing tactics and the uptick in addiction, and the company continued to push their claim that the pills were not addictive, when taken correctly. In fact, most of the time executives said the problem was inadequate pain management and that there should be more pain pills used, not less. Now whilst inadequate pain management might be an issue, it’s a separate one and one that won’t be fixed by throwing more pills at people. OxyContin was originally created for palliative care, giving 12hrs free of pain but when intake is not controlled, the consequences were dire.

Reading about Purdue Pharma is fascinating stuff – after this book was published, upwards of 36 states were suing them due to their deceptive marketing practices increasing addiction and how that had impacted socially and economically in many states. Many people didn’t start off as addicts looking for a quick fix and hearing about a new pill – they started off as people who went to their doctors for a legitimate pain issue and were prescribed a pill that didn’t live up to what it said on the box – so they took more. And became addicted. It was interesting to try and understand addiction as a beast and how little those in power often do. A lot of the time, the only rehab option available to people was a “cold turkey” type, with no medical assistance and a lot of studies show that type of rehab isn’t effective for withdrawal from opioids. In fact, according to this book, the average addict would need about 8 years of failed attempts to get clean for 12 months. However the average life expectancy of an opioid addict is just under 5 years. They’re horrific statistics – a lot of rehab facilities are run by churches and religious organisations and they don’t agree with using controlled medications in order to help people detox and feed the craving but erase the high. Most of the time, insurance doesn’t cover a facility that uses medical assistance and these facilities can run to thousands of dollars. That’s simply not an option for so many people. And even when it is an option, addiction is so tricky that it simply doesn’t always work. There were people in this book who had paid tens of thousands of dollars trying to get clean or get their children clean. Some had lost everything to the addiction as well, like a 70+yo farmer who sold his property and basically everything he owned and spent it all on the addiction. It was heartbreaking, reading so many of the stories.

I feel like this book is a great place to start if like me, you didn’t know much about this. It gives you plenty of information but without being overwhelming on science and policy and legality – and there’s so many stories of real people in here that it gives you a real appreciation of the damage this has done. And continues to do.


Book #5 of 2021

14 responses to “Review: Dopesick by Beth Macy

  1. Fantastic review. This book was incredible and so disturbing.

  2. I read a fascinating (and horrifying) report that looked into the whole ‘middle-class mum’ addiction in America that has come about from mothers injuring themselves while exercising/keeping fit after having their children and then being prescribed these pills for pain relief by the truckload and of course becoming addicts. From memory, I thought there was a judge, quite high up, whose adult daughter died of an overdose, she was a mother in her mid-thirties, successful career and had injured herself playing weekly tennis to keep fit, and that was what formed the basis of the article and the investigation. It’s truly horrid. Sounds like a gripping and eye opening read, this book.

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